The Kerala High Court has ruled in favor of the Life Insurance Corporation (LIC) in a case involving a cancer patient’s claim for insurance coverage. The claimant, a policyholder, had renewed her cancer cover in March 2021, which included a waiting period of 180 days. During this period, she was hospitalized due to bleeding and underwent several tests, including an ultrasound, histopathology, and MRI, which suggested that she had endometrial carcinoma. However, the final confirmation of cancer was made through a biopsy report on September 28, 2021, after the waiting period had ended.
The claimant argued that the diagnosis of cancer should be considered as the date of confirmation by the expert, which was after the waiting period. However, the court relied on the definition of “diagnosis” from Taber’s Cyclopedic Medical Dictionary, which states that diagnosis refers to the disease or syndrome a person has or is believed to have, and the use of scientific or clinical methods to establish the cause and nature of a person’s illness or injury.
The court held that the first diagnosis of cancer was made within the waiting period, and the subsequent confirmation by the expert was only a confirmation of the earlier reports. Therefore, the claimant was not entitled to policy coverage. The court also rejected the insurer’s contention that the claimant had suppressed the material fact that her mother had cancer, as there was no evidence to contradict the claimant’s submission that her mother was 74 years old at the time.
The court allowed LIC’s appeal and dismissed the writ petition, holding that the claimant is not entitled to cancer coverage. The judgment was made by Justices Anil K. Narendran and Muralee Krishna S. in the case of Life Insurance Corporation of India v. Haripreetha T. and Anr. (Case No: WA 1670 of 2024). The counsel for the appellant was Harish Gopinath, and the counsel for the respondents was K. Balachandran. The citation for the judgment is 2025 LiveLaw (Ker) 628.